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Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved. UAHU Salt Lake Chapter April 11, 2012 Mike Sonntag & Scott E. Deru, RHU, REBC.

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Presentation on theme: "Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved. UAHU Salt Lake Chapter April 11, 2012 Mike Sonntag & Scott E. Deru, RHU, REBC."— Presentation transcript:

1 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved. UAHU Salt Lake Chapter April 11, 2012 Mike Sonntag & Scott E. Deru, RHU, REBC

2 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved. 2 How Laws Are Made Copyright © 2012 Scott Deru & Fringe Benefit Analysts, LLC All Rights reserved. Laws

3 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved. 3 How Laws Are Made “Laws are like sausages, it is better not to see them being made.” Otto von Bismarck Copyright © 2012 Scott Deru & Fringe Benefit Analysts, LLC All Rights reserved. Laws

4 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved. 4 How Laws Are Made – United States Copyright © 2012 Scott Deru & Fringe Benefit Analysts, LLC All Rights reserved.

5 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved. 5 How Laws Are Made - Utah Copyright © 2012 Scott Deru & Fringe Benefit Analysts, LLC All Rights reserved.  Six Step Process in the House of Representatives  Entire process is then repeated in Senate

6 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved. 6 How Laws Are Made - Utah Copyright © 2012 Scott Deru & Fringe Benefit Analysts, LLC All Rights reserved.  Special Interest Groups get involved

7 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved. 7 Bill Filed and Numbered 1 st Reading Rules Committee Assigned Committee Hearing 2 nd Reading Governor 3 rd Reading Bill Filed and Numbered HOUSESENATE Copyright © 2012 Scott Deru & Fringe Benefit Analysts, LLC All Rights reserved.

8 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved. 8 Bill Passeed - Moving to Governor for approval Sent back to Rules Committee Bill Passeed - Moving to Governor for approval Bill Failed to be heard in committee - returned to Rules Committee Bill was heard and tabled in committee Bill failed on house floor Bill failed to move out of Rules Committe Bill Passeed - Moving to Governor for approval Bill failed to be heard in committee - returned to Rules Committee After bill passed the senate, it was retracted and sent back to the Rules Committee How Laws Are Made - Utah  Visit with key Legislators throughout the summer and fall  Attend events and fund raisers hosted by Legislative groups  Attend and testify at every Committee hearing involving legislation of interest to our Association What was UAHU’s Strategy?  Involve UAHU Membership: Day on the Hill Bi-weekly updates – spreadsheets and narrative Operation Shout Targeted members contact key Legislators How did we do?  Read and analyze all of the bills affecting our industry Copyright © 2012 Scott Deru & Fringe Benefit Analysts, LLC All Rights reserved.

9 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved Utah Legislative Session Copyright © 2012 Scott Deru & Fringe Benefit Analysts, LLC All Rights reserved.

10 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved Utah Legislative Session Copyright © 2012 Scott Deru & Fringe Benefit Analysts, LLC All Rights reserved. SupportOpposeWatch PassedFailedPassedFailedPassedFailed Success: 100% Bills we were tracking by title but never filed = 6 Bills we were tracking by title but later removed = 2 UAHU 2012 Scorecard

11 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved Utah Legislative Session Copyright © 2012 Scott Deru & Fringe Benefit Analysts, LLC All Rights reserved. H.B. 29 – Insurance Amendments (Dunnigan) Insurance Department Omnibus Bill – 105 page bill  Authorizes Commissioner to modify Universal Application  Approves an electronic version of the Universal Application  Insurance Department shall list the solvency rating for each carrier participating in the Exchange  Modifies the definition of the Basic Benefit Plan to be offered by Utah health insurers (the current definition expired January 1, 2012). Carriers who offer individual plans must now offer a plan comparable to the Net Care Plan with the highest actuarial value  Grants rulemaking authority to the commissioner related to determining hazardous financial condition of an insurer

12 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved Utah Legislative Session Copyright © 2012 Scott Deru & Fringe Benefit Analysts, LLC All Rights reserved.  An insurer and the insurers employees are immune from civil action when sharing information with other insurers and its employees if in good faith the effort is intended to discover or prevent a fraudulent act or other criminal activity  Provides clarification by allowing “employers” to offer the three level of Mental Health coverage in a health plan. Prior to this language it was not clear if it was an employer’s choice;  Licensees who voluntarily surrendered their licenses must now meet the CE requirements before their license can be reinstated  Provides technical corrections for lapsing or surrendering a license due to death or incompetency H.B. 29 – Insurance Amendments (Dunnigan) - continued

13 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved Utah Legislative Session Copyright © 2012 Scott Deru & Fringe Benefit Analysts, LLC All Rights reserved.  Clarification is provided to consultants versus producers with a Variable License. Licensed Producers must hold proper authority under a Broker Dealer while licensed Consultants must hold the proper credentials as a Registered Investment Advisor under the Securities and Exchange Commission H.B. 29 – Insurance Amendments (Dunnigan) - continued  Eliminates the Customer Service License

14 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved Utah Legislative Session Copyright © 2012 Scott Deru & Fringe Benefit Analysts, LLC All Rights reserved. H.B. 69 – Insurance Coverage for Autism Spectrum Disorders (Menlove) H.B. 272 – Pilot Program for Autism Spectrum Disorders (Menlove)  Two bills – One an insurance mandate, the other a pilot program  UAHU opposed the mandate – assisted in the final version of the pilot  It is difficult/politically incorrect to oppose interim studies and pilot programs  H.B. 69 (mandate bill) failed to make it out of the Rules Committee  Autism group was extremely well organized and effective  House leadership was very supportive of this bill

15 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved Utah Legislative Session Copyright © 2012 Scott Deru & Fringe Benefit Analysts, LLC All Rights reserved. H.B. 272 – Pilot Program for Autism Spectrum Disorders  Substantially scaled back from the original version:  Covers children ages 2 – 6 in Medicaid, PEHP, private sector  $4MM funding will provide benefits for 265 children  Funding coming from Medicaid, Family Services and PEHP budgets  Deductible and co-insurance were added to grant recipients  Insurance Carriers asked to donate $1,000,000 - UAHU was instrumental in language so donations are a claims expense so it would not affect MLR

16 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved Utah Legislative Session Copyright © 2012 Scott Deru & Fringe Benefit Analysts, LLC All Rights reserved. H.B. 113 – High Risk Pool Insurance Amendments (Dunnigan)  Adjusts eligibility standards for the state's high risk health insurance pool for new residents of the state who were covered by an individual policy in another state. H.B Health System Reform Amendments (Dunnigan)  Insurers can provide a premium discount for participation in a wellness program  Designates the Legislature as the entity who shall determine the Essential Health Benefit Plan under PPACA  Clarifies fees that can be charged by the Utah Exchange Call Center  Authorizes an actuarial study to determine the cost of increasing eligibility for Medicaid from 133% to 200% of the FPL in PPACA

17 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved Utah Legislative Session Copyright © 2012 Scott Deru & Fringe Benefit Analysts, LLC All Rights reserved. H.B. 211–Insurance Coverage for Amino Acid-Based Formula (Moss) Two Bills UAHU Testified Against: H.B. 64 – Amendments to Public Employees Health Care (Doughty)  Would have mandated that insurers cover amino acid- based formula if medically necessary for any person unable to process whole, fatty or carb based foods.  Coverage would have been allowed for an unmarried “adult designee”  Has lived with an eligible employee for the last 12 months  Share common financial obligations any 3 of a list of stated documents

18 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved Utah Legislative Session Copyright © 2012 Scott Deru & Fringe Benefit Analysts, LLC All Rights reserved. H.B. 214 – P.E.O. Licensing Act Amendments (Dunnigan)  Requires Professional Employer Organizations to comply with three sections of the Insurance Code in their business practices: PEO’s must offer Mini COBRA to eligible employees under the Code PEO’s must comply with “Unfair Marketing Practices” under the Code PEO’s must comply with the “Illegal Inducement” section of the code passed in 2011 also known as H.B. 333 Did not include fee disclosure

19 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved Utah Legislative Session Copyright © 2012 Scott Deru & Fringe Benefit Analysts, LLC All Rights reserved. H.B. 242 – Insurance Billing for Athletic Trainers (Ray) S.B. 264 – Judicial Code Amendments (Davis)  These bills would have designated Athletic Trainers as “Healthcare Providers” allowing them to bill insurance companies directly.  The Senate Bill: - Was assigned to the Judicial Committee - Passed the Senate overwhelmingly - Was recalled from the House by the Senate - Final vote 0 Yeas 0 Nays 29 Abstain - Was sent to Senate Rules Committee where it died  The bill was never heard in the House

20 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved Utah Legislative Session Copyright © 2012 Scott Deru & Fringe Benefit Analysts, LLC All Rights reserved. S.B. 138 – Health Insurance Mandate Accountability Amendments (Weiler)  Current law requires any mandate have a fiscal note for PEHP  This bill would add funding for: - Public Schools - Charter Schools - State funded institutions of Higher Education  Retroactive back to January 1, 2012  Passed at 10:45 p.m. the last day of the session

21 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved Utah Legislative Session Copyright © 2012 Scott Deru & Fringe Benefit Analysts, LLC All Rights reserved. S.B. 208 – Healthcare Compact (Adams)  Joins Utah with a host of other states requesting that the Federal Government send all health care funding to the State in the form of a block grant.  Would require approval from Congress  Not likely with democratic control of the U.S. Senate

22 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved Utah Legislative Session Copyright © 2012 Scott Deru & Fringe Benefit Analysts, LLC All Rights reserved.  Reviewed 12 of 32 Bills we tracked during the session What’s Next? HUPAC

23 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved. Questions ??? Scott E. Deru, RHU, REBC

24 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved. UAHU Analysis of the Supreme Court Hearing on PPACA April 5, 2012 Scott E. Deru, RHU, REBC

25 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved. 25 U.S. Supreme Court Hearing on PPACA Copyright © 2011 Scott Deru & Fringe Benefit Analysts, LLC All Rights reserved. Multiple Lawsuits 26 States and NFIB 4 Issues Heard - 3 Days - Six Hours of Oral Arguments (extended 30 minutes) - Anti-Injunction Act –Tax or Penalty? - Interstate Commerce Clause - Individual Mandate Legal? - Severability - Federal Overreach on States

26 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved. 26 U.S. Supreme Court Hearing on PPACA Copyright © 2011 Scott Deru & Fringe Benefit Analysts, LLC All Rights reserved. U.S. Congress H.R Co-sponsors Votes needed to pass the House -S.B Bi-partisan original sponsors - Being re-filed to address concerns from other trade association

27 Copyright © 2010 United Benefit Advisors, LLC. All Rights Reserved. Questions ??? Scott E. Deru, RHU, REBC


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